Emotional disclosure and pain symptoms : a brief intervention with back pain patients : 6 single cases
Back pain affects an estimated 70% of adults at some point during their lifetime.
Approximately 1 % of these develop chronic pain - a disabling state characterized
by persistent pain with associated psychological and social problems. Research
has identified a number of psychosocial factors which are associated with the
progression from acute to chronic pain. These include a high incidence of
traumatic life events and negative affect, low satisfaction with social support,
reduced self-efficacy and a tendency to inhibit the expression of negative affect.
Research indicates that writing about traumatic events is associated with
therapeutic effects on physical and psychological health. A number of psychosocial
mechanisms which may contribute to these beneficial effects have been
proposed. One argument holds that benefits are due to disinhibition at both a
physiological and psychological level. A second hypothesis attributes the effects
to changes in cognitive processes which facilitate improvements in coping and
self-efficacy. Emotional disclosure may also result in greater social integration,
allowing the individual to relate more openly with others. It may therefore be an
effective intervention in chronic pain conditions which are associated with deficits
in self-efficacy and emotional expressiveness and low satisfaction with social
support in the context of a high incidence of stressful life events.
This study which comprised six single cases, investigated the effects of writing
about stressful events on pain and distress. Participants were patients with
chronic back pain attending outpatients' physiotherapy or osteopathy clinics.
Two (of 3) participants in the intervention condition, reported clinically Significant
decreases in depression and functional limitation three weeks following the
intervention. There was no evidence of improvement in participants in the control
condition. Results are discussed with reference to methodological weaknesses
and suggestions for future research are presented.